title: Role of the superior labrum after biceps tenodesis in glenohumeral stability.
abstract: BACKGROUND
  Little is known about the role that a torn superior labrum (SLAP) plays in glenohumeral stability after biceps tenodesis. This biomechanical study evaluated the contribution of a type II SLAP lesion to glenohumeral translation in the presence of biceps tenodesis. The authors hypothesize that subsequent to biceps tenodesis, a torn superior labrum does not affect glenohumeral stability and therefore does not require anatomic repair in an overhead throwing athlete.
  
  
  METHODS
  Baseline anterior, posterior, and abduction and maximal external rotation glenohumeral translation data were collected from 20 cadaveric shoulders. Translation testing was repeated after the creation of anterior (n = 10) and posterior (n = 10) type II SLAP lesions. Translation re-evaluation after biceps tenodesis was performed for each specimen. Finally, anatomic SLAP lesion repair and testing were performed.
  
  
  RESULTS
  Anterior and posterior SLAP lesions led to significant increases in glenohumeral translation in all directions (P < .0125). Biceps tenodesis showed no significance in stability compared with SLAP alone (P > .0125). Arthroscopic repair of anterior SLAP lesions did not restore anterior translation compared with the baseline state (P = .0011) but did restore posterior (P = .823) and abduction and maximal external rotation (P = .806) translations. Repair of posterior SLAP lesions demonstrated no statistical difference compared with the baseline state (P > .0125).
  
  
  CONCLUSIONS
  With no detrimental effect on glenohumeral stability in the presence of a SLAP lesion, biceps tenodesis may be considered a valid primary or revision surgery for patients suffering from symptomatic type II SLAP tears. However, biceps tenodesis should be considered with caution as the primary treatment of SLAP lesions in overhead throwing athletes secondary to its inability to completely restore translational stability.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Strauss
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Salata
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA. Electronic address: bob.sershon@gmail.com.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sershon
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Nickolas
authors.initials: N
authors.lastname: Garbis
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Provencher
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: McGill
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Bush-Joseph
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Nicholson
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cole
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Romeo
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Nikhil N
authors.initials: NN
authors.lastname: Verma
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D016059:Range of Motion, Articular; D012399:Rotation; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery; D053656:Tenodesis; D055815:Young Adult
keywords: SLAP; Shoulder; biceps tenodesis; glenohumeral kinematics; superior labrum